Nemoto Tetsutaro, Endo Shungo, Isohata Noriyuki, Takayanagi Daisuke, Nemoto Daiki, Aizawa Masato, Utano Kenichi, Togashi Kazutomo, Endo Kotaro, Oshibe Ikuro, Soeta Nobutoshi, Saito Takuro
Dept. of Coloproctology, Aizu Medical Center, Fukushima Medical University.
Gan To Kagaku Ryoho. 2019 Jan;46(1):130-132.
A 53-year-old woman was referred to our hospital with melena. Examinations revealed advanced rectal cancer involving the anal canal with invasion of the left-sided levator ani muscle. Neoadjuvant chemotherapy was administered to preserve anal function. A first course of capecitabine and oxaliplatin(CapeOX)plus bevacizumab was administered. CapeOX plus panitumumab was administered from the 2nd to the 8th courses after confirming the absence of RAS mutation. Endoscopy and computed tomography confirmed the disappearance of the tumor after completion of the chemotherapy. A biopsy of the scar tissue revealed no cancer cells. However, diffusion weighted-magnetic resonance imaging(MRI-DWI)revealed a suspected residual tumor. To determine the subsequent treatment, a transanal resection was performed. No carcinoma was identified in the specimen. Thus, additional surgical treatment and adjuvant chemotherapy were not administered. The patient was followed-up over 2.5 years post local resection and showed no recurrence.
一名53岁女性因黑便被转诊至我院。检查发现晚期直肠癌累及肛管，并侵犯左侧肛提肌。给予新辅助化疗以保留肛门功能。给予第一疗程的卡培他滨和奥沙利铂（CapeOX）加贝伐单抗。在确认无RAS突变后，从第2疗程至第8疗程给予CapeOX加帕尼单抗。化疗完成后，内镜检查和计算机断层扫描证实肿瘤消失。瘢痕组织活检未发现癌细胞。然而，扩散加权磁共振成像（MRI-DWI）显示有疑似残留肿瘤。为确定后续治疗方案，进行了经肛门切除术。标本中未发现癌组织。因此，未进行额外的手术治疗和辅助化疗。患者在局部切除术后接受了2.5年的随访，未出现复发。
